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Cureus 2021 Jul 27;13(7):e16677. Epub 2021 Jul 27.

Physical Medicine and Rehabilitation, Interventional Orthopedics and Regenerative Medicine, Interventional Orthopedics of Atlanta, Atlanta, USA.

Osteonecrosis (ON) is a painful condition involving bony cell death with resultant architectural collapse. This report discusses the case of a 50-year-old Caucasian female who presented to an outpatient musculoskeletal clinic with severe chronic left knee pain. She had a history of ulcerative colitis and resultant chronic corticosteroid exposure with subsequent development of knee ON. Read More

BMJ Case Rep 2021 Jul 23;14(7). Epub 2021 Jul 23.

Department of Pediatric Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India

Perthes disease and slipped capital femoral epiphysis (SCFE) in the same child is a rare occurrence. A 7-year-old boy with the left hip Perthes' disease was managed with femur osteotomy. The femur head healed with a spherical congruent hip. Read More

JBJS Essent Surg Tech 2021 Apr-Jun;11(2). Epub 2021 May 12.

Shriners Hospitals for Children, Philadelphia, Pennsylvania.

Background: The goal of the osteochondral autograft transplantation (OAT) procedure is to replace both the bone and cartilage that have been compromised by osteonecrosis of the capitellum, a condition known as osteochondritis dissecans (OCD). In children, the vascularity of the capitellum is limited compared with that in adults because the physis acts as a physical barrier to vascular ingrowth from the metaphysis to the epiphysis. The necrotic subchondral bone cannot keep up with the weight-bearing demands of certain high-level athletes such as gymnasts, accumulating microfractures and eventually crumbling. Read More

Arch Orthop Trauma Surg 2021 Jul 16. Epub 2021 Jul 16.

Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.

Introduction: Unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are established treatments for medial compartment osteoarthritis (OA) or osteonecrosis (ON) of the knee joint, and the predominance of either procedure is inconclusive. We compared the awareness of the knee after UKA and HTO using the Forgotten joint score-12 (FJS).

Materials And Methods: This was a retrospective, multicenter study. Read More

Lupus 2021 Jul 14:9612033211031007. Epub 2021 Jul 14.

Department of Orthopaedics and Traumatology, Koç University Hospital, Istanbul, Turkey.

Objective: Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse of the architectural bone structure secondary to the death of the bone marrow and trabecular bone. Osteonecrosis may accompany many conditions, especially rheumatic diseases. Among rheumatic diseases, osteonecrosis is most commonly associated with systemic lupus erythematosus (SLE). Read More

Knee 2021 Aug 30;31:164-171. Epub 2021 Jun 30.

Department of Orthopaedic Surgery, Gunma University, Maebashi, Gunma, Japan.

Background: Risk factors for the progression of spontaneous osteonecrosis of the knee (SONK) remain unclear. The purpose of this study was to investigate the association between magnetic resonance imaging (MRI) findings of the meniscus and the prognosis of SONK.

Methods: A total of 78 consecutive patients (female 85%; mean age 75. Read More

Biomolecules 2021 Jun 25;11(7). Epub 2021 Jun 25.

Department of Biomedical Engineering, National Taiwan University, Taipei 10617, Taiwan.

We demonstrated the safety and efficacy of autologous chondrocyte precursor (CP) cell therapy in repairing Grade 4 cartilage defects of medial femoral condyles. The autologous bone marrow mesenchymal stem cells of each participant were isolated, amplified, and then differentiated into CPs in atelocollagen. Neotissues made of CPs were implanted into cartilage defects with an average cell density of 4. Read More

Rheumatology (Oxford) 2021 Jun 27. Epub 2021 Jun 27.

Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Objectives: To assess the prevalence of avascular necrosis (AVN) in a large cohort of patients with idiopathic inflammatory myopathies (IIM) and define the major associated risk factors.

Methods: We retrospectively reviewed the electronic medical records of all patients with a definitive diagnosis of IIM enrolled in our registry between 2003-2017 and followed until 2020. Pertinent demographic, clinical, serologic and imaging data were collected. Read More

J Surg Case Rep 2021 Jun 17;2021(6):rjab242. Epub 2021 Jun 17.

Unort.E Hospital de Ortopedia, Londrina, PR, Brazil.

Spontaneous osteonecrosis or subchondral bone insufficiency fracture of the knee is a frequent injury in elderly female patients. The medial femoral condyle followed by the medial plateau is the most prevalent sites. When its evolution after conservative treatment is not favorable, medial unicompartimental arthroplasty is a surgical option with good results. Read More

J Orthop Case Rep 2021 Feb;11(2):112-118

Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India.

Introduction: Hoffa fractures are the fractures of the femoral condyles in the coronal planes. These are uncommon in adults and notably rarer in pediatric population. In this fracture, either one or both the femoral condyles may get involved following the injury. Read More

Cartilage 2021 Jun 17:19476035211023566. Epub 2021 Jun 17.

Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, Beijing, China.

Background: Only a few studies exist that have assessed the efficacy of autologous osteochondral transplantation (AOT) treatment of osteonecrosis (ON) of the knee. The purpose of this study was to clarify the clinical and radiographic results of AOT performed on young patients with postcollapse ON of the knee.

Methods: This retrospective study included 14 young patients (6 men, 8 women, mean age 34. Read More

J Orthop Surg Res 2021 Jun 9;16(1):369. Epub 2021 Jun 9.

LANS Medicum Hamburg - Center for Sports and Regenerative Medicine, Stephansplatz 5, 20354, Hamburg, Germany.

Background: Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME. Read More

Surg Technol Int 2021 05 27;38. Epub 2021 May 27.

Medicine Team Leader, Pfizer Inc, Groton, Connecticut.

Introduction: This prospective cohort study (ClinicalTrials.gov identifier: NCT02674386) evaluated the postoperative outcomes of patients who had undergone total joint replacement (TJR) while participating in one of three tanezumab (a nerve growth factor inhibitor) randomized phase 3 osteoarthritis (OA) studies.

Materials And Methods: Eligible patients were those who underwent TJR (knee, hip, or shoulder) at any time during any of three tanezumab randomized phase 3 OA studies. Read More

Zhongguo Gu Shang 2021 May;34(5):417-24

Osteonecrosis and Joint Reconstruction Ward, Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China.

Objective: This study aimed to research whether anterior tibial crest is a reliable anatomical reference for rotational alignment of tibial component in TKA.

Methods: The study included 122 patients who underwent computed tomography angiography (CTA) examination for unilateral lower extremity trauma with normal contralateral lower extremities, including 89 males and 33 females, with an average age of(51.4±16. Read More

Biomed Res Int 2021 30;2021:6614122. Epub 2021 Apr 30.

Department of Orthopedics Surgery, Mackay Memorial Hospital, Taipei City, Taiwan.

Background: Spontaneous osteonecrosis of the knee (SONK) can lead to severe knee osteoarthritis predominantly localized to the medial compartment. We aimed to determine whether unicompartmental knee arthroplasty was an effective treatment for primary SONK.

Methods: We analyzed the functional outcomes in 23 patients with SONK (with a magnetic resonance imaging- (MRI-) confirmed diagnosis) who underwent UKA at a single center. Read More

J Am Acad Orthop Surg Glob Res Rev 2020 11 12;4(11):e20.00095. Epub 2020 Nov 12.

From the Department of Orthopedic Surgery, University of Massachusetts Medical School, Worcester, MA (Dr. Yousef and Dr. Ayers), and the Department of Orthopaedic Surgery, Sohag University, Sohag, Egypt (Dr. Yousef).

We present the first report of bilateral knee and left ankle osteonecrosis in a 58-year-old female patient on long-term intranasal corticosteroids. Initially, our patient presented with progressive disabling knee pain with normal radiographs. The patient was presumed to have mild degenerative joint disease; therefore, she was treated conservatively. Read More

Arthritis Care Res (Hoboken) 2021 May 10. Epub 2021 May 10.

Pfizer Inc, Groton, Connecticut, USA.

Objective: This pooled analysis of 3 randomized, placebo-controlled trials (16─24 week treatment; 8─24 week follow-up) assessed safety of subcutaneous tanezumab (2.5─10 mg every 8 weeks) in 1840 patients with hip or knee osteoarthritis.

Methods: Overall treatment-emergent adverse events (TEAEs) and TEAEs of abnormal peripheral sensation (APS) were prospectively assessed in 3 trials. Read More

Osteoarthr Cartil Open 2021 Jun 16;3(2). Epub 2021 Apr 16.

Boston University School of Medicine, Boston, MA, USA.

Background: Anti-nerve growth factor (NGF) has shown promise for osteoarthritis (OA) pain efficacy, but an unanticipated joint safety signal occurred in trials. To what extent this was related to OA natural history, or was a consequence of anti-NGF agents is unclear. Of the adverse joint safety events identified, osteonecrosis has specific diagnostic codes available in the medical record to enable assessment of its frequency in the general community. Read More

Rev Bras Ortop (Sao Paulo) 2021 Apr 22;56(2):133-137. Epub 2020 Jul 22.

Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

Medial arthrosis of the knee is an evolutionary pathology that occurs due to progressive muscle imbalance. The muscles of the knee region have a large imbalance caused by the difference of power and lever arm. With the progression of life, this imbalance manifests itself more importantly, especially due to the loss of muscle strength due to aging. Read More

Bone Joint J 2021 May;103-B(5):840-845

Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza, Brescia, Italy.

Aims: In the last decade, interest in partial knee arthroplasties and bicruciate retaining total knee arthroplasties has increased. In addition, patient-related outcomes and functional results such as range of movement and ambulation may be more promising with less invasive procedures such as bicompartmental arthroplasty (BCA). The purpose of this study is to evaluate clinical and radiological outcomes after a third-generation patellofemoral arthroplasty (PFA) combined with a medial or lateral unicompartmental knee arthroplasty (UKA) at mid- to long-term follow-up. Read More

Arthroscopy 2021 05;37(5):1597-1598

La Jolla, California.

Fresh osteochondral allograft transplantation has been my preferred procedure for chondral and osteochondral lesions for many decades. This is particularly true for patients younger than 18 years of age, where diagnoses such as osteochondritis dissecans, osteochondral fractures, and osteonecrosis predominate, rendering the situation as much a "bone problem" as a "cartilage problem." In the universe of cartilage-repair techniques, osteochondral allografts are particularly useful when bone defects must be managed. Read More

Skeletal Radiol 2021 Apr 17. Epub 2021 Apr 17.

Department of Radiology and Imaging Sciences Section of Musculoskeletal Imaging, Emory University Hospital, 59 Executive Park South, 4th Floor Suite 4009, Atlanta, GA, 30329, USA.

Objective: To assess the relationship between low- and high-grade subchondral insufficiency fracture of the knee (SIFK) and meniscal tear/type/location, severity of meniscal extrusion, grade of chondrosis, and extent of surrounding edema-like marrow signal intensity.

Materials And Methods: Our retrospective study included 219 patients with knee pain and SIFK seen on MRI. SIFK lesions were categorized from grade 1 to 4 with a low grade (1 and 2) vs high grade (3 and 4) distinction. Read More

Cureus 2021 Mar 10;13(3):e13801. Epub 2021 Mar 10.

Trauma and Orthopaedics, University Hospitals of Derby and Burton NHS Foundation Trust, Burton-on-Trent, GBR.

Skeletal trauma accounts for 10% to 15% of all childhood injuries, with approximately 15% to 30% of these representing physeal injuries. Talus fractures are rare injuries in children with an estimated prevalence of 0.008% of all childhood fractures. Read More

Anesth Prog 2021 03;68(1):26-28

Professor of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

A 36-year-old man underwent direct laryngoscopy with routine general anesthesia for a knee procedure. Several days later, he experienced pain involving an ulceration along the medial aspect of the right mandible in the floor of the mouth. This evolved to a painful bony mass, and subsequently, a bony sequestrum was spontaneously shed. Read More

Acta Ortop Bras 2021 Jan-Feb;29(1):12-16

Takatsuki General Hospital, Department of Orthopedic Surgery and Joint Surgery Center, Takatsuki, Osaka, Japan.

Objective: Although the mobile-bearing Oxford unicompartmental knee arthroplasty (OUKA) seems an appropriate procedure to treat spontaneous osteonecrosis of the knee (SONK), aseptic tibial component loosening was the leading cause for medial UKA failure. This study aimed to observe short-term and midterm clinical outcomes following OUKA and determine whether tibial lesion affects the procedure clinical and radiographic outcomes.

Methods: Sixty patients (mean age 73. Read More

Sci Rep 2021 Mar 31;11(1):7297. Epub 2021 Mar 31.

Osteonecrosis and Joint Reconstruction Ward, Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, People's Republic of China.

Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. 247 TKAs in 213 patients were reviewed. We included 104 Legion Prosthesis, 76 U2 Knee Prosthesis, 46 NexGen LPS-Flex Prosthesis, and 21 Vanguard Knee System products. Read More

Int J Surg Case Rep 2021 Apr 11;81:105746. Epub 2021 Mar 11.

Department of Orthopedics and Traumatology, Bezmialem Vakif University School of Medicine, Vatan Cd, Fatih, 34093, Istanbul, Turkey.

Introduction And Importance: Anteromedial osteoarthritis (AMOA) is a common knee pathology. However, the best treatment of AMOA remains unclear. Unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are surgical options for AMOA patients who do not benefit from conservative treatment. Read More

J Orthop Case Rep 2020 Oct;10(7):25-29

Department of Orthopedics, Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, Maharashtra, India.

Introduction: Osteonecrosis of knee is classified as primary spontaneous osteonecrosis of knee (SPONK) and secondary osteonecrosis of knee. Primary SPONK usually involves medial femoral condyle (MFC). Incidence of medial tibial plateau (MTP) is only 2% among the patients with SPONK and simultaneous involvement of MFC and MTP is very rare. Read More

J Knee Surg 2021 May 5;34(6):587-591. Epub 2021 Feb 5.

Division of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York City, New York.

Posterior cruciate ligament (PCL) injuries often occur as part of a multiligament injury pattern and can present a significant challenge to the treating surgeon. When PCL reconstruction is indicated, complications can arise in the intraoperative and postoperative period that lead to poor outcomes. These complications include neurovascular injury, fracture, compartment syndrome, persistent posterior laxity, motion loss, residual knee pain, osteonecrosis, and heterotopic ossification. Read More

Ocul Immunol Inflamm 2021 Feb 4:1-7. Epub 2021 Feb 4.

Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

: To identify the prevalence, risk factors and outcomes of avascular necrosis (AVN) in patients with chronic uveitis.: A retrospective study of patients with corticosteroid-induced AVN treated at Manchester Uveitis Clinic between 1991 and 2019.: From a cohort of 4478 patients, 1698 had been treated with systemic corticosteroids. Read More